No matter why you want to go to the chiropractor — herniated disc, TMJ pain, sciatica — you want to know what insurance will cover and what costs you’re responsible for before scheduling an appointment. When you dig into the details, you discover you need a referral to see a chiropractor.
But what if you can’t get a referral or don’t have a primary care doctor to ask? Can you see a chiropractor with a referral? The short answer is yes, but there’s more to it than that.
Can I See a Chiropractor Without a Referral?
In general, you don’t need a referral from your medical doctors or primary care providers for chiropractic care and adjustments. Most chiropractors are happy to see you without one. However, depending on the specifics of your situation or medical condition, you may need a referral.
Some insurance plans require you to get a referral from a medical doctor or primary care physician before your first visit to see the chiropractor. Not getting this referral could mean your insurance company won’t pay for the chiropractic visits. Many workers compensation plans also require a referral to the chiropractor before the first visit.
Do Primary Care Providers Have to Provide a Referral for Chiropractic Care?
Chiropractic care is generally considered a specialty service, just like seeing a neurologist or gastroenterologist is, and many insurance companies require a referral for specialty care. The referral means your primary care physician can’t provide the special care and services you need, so they’re referring you to a medical doctor who specializes in that service.
However, your physician is not required to give you a referral for any kind of specialty care, though most will if you explain why you want it. If your primary care provider won’t give it to you or you don’t have a primary care provider, you can try another doctor, urgent care center, or telemedicine provider.
When Should I Get a Referral for Chiropractic Care?
Most chiropractors are happy to see new patients without a referral. However, if your insurance plan includes a benefit for chiropractic services and you want to use it, you’ll likely need a referral before your first appointment. Check with your insurance company to confirm the details.
Some patients choose to get a referral to the chiropractor to keep their doctor informed about all the medical care and treatments they’re pursuing. If your primary care provider knows you’re interested in and getting chiropractic care, they’re better able to coordinate their treatment plan with the chiropractor to ensure your treatments and other care don’t interfere with each other.
What If My Insurance Won’t Cover Chiropractic Even With a Referral?
Not every insurance company is in-network with every chiropractor, and not every insurance plan offers a chiropractor benefit. Fortunately, there are ways to pay for the chiropractor that don’t require insurance:
- Health savings account (HSA). You can tap into your HSA to pay for chiropractor visits. These plans are only available to people who had (or once had) a high-deductible health plan.
- Flexible spending account (FSA). You may have an FSA through your employer that’s funded by your pre-tax dollars and can be used to pay for chiropractic adjustments.
- Personal injury coverage (PIP). If you were injured in a car accident and your car insurance policy includes PIP, you may be able to use it to pay for your chiropractor visits.
You can also pay out-of-pocket for your chiropractic adjustments. Many chiropractors take cash or credit cards, and some may be open to a payment plan.
Referrals Matter Most of the Time
While many insurance companies require a referral to see the chiropractor before your first visit, not all do. Getting a referral may be an extra step or two, but it’s worth it if you want to go through the insurance company. And, fortunately, if you can’t get a referral or want to keep insurance out of it, many chiropractors are willing to see you without a referral as long as you pay out of pocket for your treatments.
Flourish Chiropractic Spa is in-network with many PPO plans, and we’re happy to bill any insurance company as a courtesy to you. We’ll also provide you with a Superbill if you prefer to submit the information to the insurance company yourself.
We’re here to help you on the path to pain relief and better health. Schedule an appointment today.
